Although motivational interviewing is often used to address addiction and is well-known intervention, more than 20 professionals working with the addicts welcomed the possibility to attend the workshop “Motivational Interviews with Addicted Clients”, which took place on 7 December 2018 in the Welfare Department of the Riga City Council. This intervention helps people become motivated to change the behaviors that are preventing them from making healthier choices.
What is addiction and what are its causes? There are a lot of definitions, explained Ms Katrina Reikmane, a very experienced psychotherapist and couch - a trainer at this workshop. She presented the personality profile of an addict and explained their emotional needs. The addiction recovery plan was also presented and analysed.
Motivation is an internal interest, which causes person’ s activity and drives their actions. During the workshop it was stressed that internal motivation is stronger than external if it is rooted in one’s satisfaction of emotional needs and values. The principle of motivation which is “directive, person centred counselling style that aims to help people explore and resolve their ambivalence about behavioural change” (Michael Wilesand Cross Country Education, Inc.2005) was also explained. The participants of the workshop were practically involved and were invited to accomplish various tasks in pairs. Everybody had to choose one’s own goal which requires change of behavioral habits and which they have had difficulties to achieve so far, such as losing one's weight, stop eating sweets, drinking too much coffee. Then the other colleague had to use motivational interview to help his/her partner reach the set goal.
Motivation traps and ways how to avoid them are of great importance. The trainer stressed that there is danger for the professional not to “merge” with the client and become unhelpful. There is also danger that a professional could lose one’s belief and motivation. The importance of cooperation among various specialists was underlined. The participants were very positive about the workshop: “Very satisfied with the workshop! It was good that theory was mixed professional exchange of experience and practical tasks.“
By Aija Vecenane, Riga City Council Welfare Department
MUCH MORE project Turku tested archery and experienced moments of mindfulness.
Take a good position and stand straight. Be calm, breathe and relax. Concentrate, concentrate and concentrate. Focus on the target.
This might sound like some kind of mindfulness or meditation practice but actually I’m talking about archery – a sport that MUCH MORE team in Turku tried last week.
The group of six men participated in this peer group session that was a bit different from any other group sessions we have had before. Two trainers from a local archery team taught our Much More group the basic techniques. None of the group participants had tried archery before. To them it was something totally new.
During this group session the men hardly talked though speaking was not denied. The guys who normally tell jokes stayed nearly quiet this time. That’s because speaking while shooting arrows is nearly impossible. Multi-tasking and archery is a combination that just doesn’t work.
Archery is demanding though the basic technique is quite simple. It seems that you just need to stand and shoot. But if your mind is wandering it is nearly impossible to hit the target. Relaxation, focusing and concentration are necessary for perfect shots. You must really calm your nerves before you can release the bowstring and shoot. Otherwise you don’t shoot well.
This is how practicing archery resembles practicing mindfulness, the art of being present. Archery can teach you how to control your attention and regulate your emotions. It can help you to become more mindful and more able to concentrate.
We finished our archery session with a playful shooting competition. Our clients got a chance to release their inner Robin Hood. It was fun and freeing. All in all – they enjoyed themselves and left the group session happy and calm. We managed to hit the bulls-eye.
By Terhi Toppala, Blue Ribbon Association of Southwest Finland
While the MUCH MORE project is going slowly to the end with six months of activities left, the groups in Gävle, Turku and Riga continue to meet and support each other. Last week, the Gävle group was visited by Anders Nilsson, who runs his own company working with our target group but also other groups. Anders is also an addiction therapist, he used to be a football player e.g. at the elite level Gävles football team. Previously he worked with rehabilitation of sports injuries but is anow focused on "Aware Breathing".
The one applied during the first meeting with MUCH MORE group, was a simpler form and on the next occasion, we will try a "stronger form" of aware breathing that will last for a long time.
"Aware Breathing" originates in a method called "Rebirthing". "We in the West have lost the insight that the head and body are together as a unit." Experiences, crises, traumas "settle in the body and the body remembers".
Anders says that for a long time ago when people were hunters, the body and brain were 80% dormant while 20% were in preparedness to see if some kind of danger. In today's modern Western societies, the relationship is the reverse.
Mr Nilsson told the group about how he had experienced it at the first moment he tried releasing breathing when the "pressure over the chest dropped" and all stress left the body and head. He said that his emotions were set free.
After we had tried the simpler form which Anders called the 3*30 method the hole group felt that they wanted to try the more intense form next week.
By Johan Pliakas, STICKAN
The project MUCH MORE has launched its video clip promoting the empowering and peer-group activities towards men with past addition problems at the Central Baltic Programme Annual Event taking place in Turku on 14-15 November. Positive comments like ”It was an absolute pleasure to watch that video, thank you” were received.
In the video, the professionals working with the target group shared their opinions about what does the project bring to the lives of men, what can they learn from this experience and what comes to their mind when they think "MUCH MORE project". At the same time, the feedback of the target group is presented. The video can be watched on youtube: https://youtu.be/mPPd3SLTN9g
MUCH MORE project partners from Gävle, Turku and Riga gathered together in Riga on a study visit on 16-17 October to share the gained experience in working with men with past addiction problems, exchange ideas for peer group activities and discuss the plans for further actions.
During the days in Riga, the international project team had the possibility to participate on site visits, offered by the hosts of Riga. The first site visit took the team to a social rehabilitation center called NOVA VITA. The visit began with an introduction of the Betlehem Charity House by Dana Anskaite and Liga Roke-Reimate. NOVA VITA offers a rehabilitation program for addicted adults. A multiprofessional group is working with the men to offer them support through the daily program.
Work and social issues, health and relationship problems and topics like self-worth, identity and values are daily issues, which are being processed among the men with the help of professionals. Men live in a shared the community and they are being encouraged to develop their practical skills in every-day and spiritual life. As taking the tour around the building, partners could meet some of the men, have a chat with them and ask about their feedback towards the MUCH MORE project. Men said that they are particularly happy with the cooking classes and one men said that the physical activities “brought him to life”.
Next stop at the social rehabilitation center RATNIEKI, which is located outside of the city of Riga. The rural surroundings of the center impressed the project team right away. RATNIEKI was established in 1998 and since then it has been the base for the men participating the MUCH MORE project.
Also in this center, men have a daily schedule to be followed. Sports, different kind of wooden work, cooking classes and several other kind of activities are offered by multiprofessional team of therapists, social workers, artists etc. One of the most impressive concrete achievements of the team work at the center was clearly a residential cottage which the men have built together. Again, the team had the possibility to get to know the facilities of the center, have a little chat with some of the men and see how men are living.
Additionally, there are more exciting things happening in the MUCH MORE project: a video clip about the project is under development! It will offer you a short insight into our project by showing an interview with the partners, describing the project in shortcuts and letting the professionals know what the peer-group activities bring to the work with the difficult-to-reach target group.The video clip will be published soon on our webpage, don´t miss it!
There was a crowd of people from all round the world discussing and learning about the projects and achievements of participating associations, organizations and cities, which are presented in posters at the International Healthy Cities Conference 2018 that took place 1-4 October at Waterfront in Belfast, Northern Ireland. The moderate poster walk was one of the multifaceted and interesting program of the conference.
Iina Lenz, the project coordinator of BRHCA took part of the poster walk among many others by presenting the MUCH MORE project. That was an opportunity for the other conference delegates to get to know more about the presented projects. Questions like how men experienced the activities, if cooperation partners do learn from each other´s experiences during the project and if the project has really reached men to participate, occurred during the walk.
“Gladly we can announce that we have reached a group of men in all partner countries and have received positive and constructive feedback from them. Thanks to MUCH MORE, men had a possibility to take part in designing and developing the activities together with the professionals. We have been in an intensive cooperation among the partners and have had interesting discussions about the achievements and challenges to develop more interesting and more empowering activities for the target group.” Iina reported.
Despite the hot summer days, the workshops in Riga for men continue. The following short insight into a music and art workshop provides a glimpse of the activity.
It is Monday afternoon and all the participants are seated in a circle. This time there are five men. All of them have participated also in the previous workshops and they are not surprised when asked to choose an instrument which best suits one’s mood on this day. Although there is a wide range of musical instruments, they act quickly. The participants are very different in their preferences – they choose from the loud drums to the whisper-like sound of the "rain tree". Each person is invited to justify his choice. Then each of the participants names three things that would help them to overcome bad mood and start feeling happier. The answer is not simple, especially for these men with alcohol addiction in the past. One participant is confused because alcohol and drugs were his support in past but what could substitute them at this moment? Friends, family, religion, work..? Another participants mentions music, conversations with friends (but then he sadly remarks that there is no longer any friends outside the centre). Other men mention also need to stay in silence with one’s thoughts. The next task is to make the same "dark day" symbolically bright - the three things already mentioned are to be put on a black sheet of paper so that the overall impression is light. The men are very eager to make their drawings and choose the crayons. Afterwards the men try to explain their ideas and drawings. Then two drawings are selected to be “played out”. Everybody has to choose and “play” some musical instrument, altogether creating a common “orchestra”. At the same time it is to be kept in mind that one has to play in such a way as not to disturb the others. And it really works! Men are really interested and try to play while listening to others. And quite unexpectedly the workshop has come to the end.
The goal of these of activities is to build strong internal resources – a sense of personal control over a situation. Such kind of activities also help to raise awareness that the surrounding people and society can be supportive and helpful to deal with dark moods and complicated situations.
During June we have had four peer group meetings. Together with the clients we have eaten self-made fish soup, fixed bikes and played a typical Finnish outdoor summer game called Mölkky.
The number of participants in the peer group meetings has varied from zero to six. It seems that few men have committed to the group. The others come and go, appear in the meetings and then disappear. Some of them respond to messages that we send to them to inform them about coming peer group meetings. Some of them even call us. We might have long telephone conversations with them, but when it is time to come to the meetings the men are not there – even though on the phone they have promised to be there. Also, some of the men have lost their phone connections in a couple of weeks’ time and we have lost the contact with them.
We discussed these problems with our colleagues from our local partners, Sininauha Oy and A-kilta, which are organizations that work with substance abusing clients or former alcoholics. The colleagues agreed with us: it is a very typical phenomenon among the clients of this target group. The clients have difficulties with committing to the group meetings or other activities. The summer time highlights these problems. During winter many clients take part in this kind of activities more actively but in the summer time they find something else to do – or don’t do anything special, which is more common.
Sometimes even getting out of one’s own home can be a huge psychological effort for our clients. It’s typical that they have decided and promised beforehand to attend some activity – and they have truly believed that they are really going to do that. But when they should leave their homes they just can’t do it, for one reason or another. There are also more practical explanations why our clients don’t always show up even though they have said that they will. They have told us that they don’t have money to buy bus tickets or they don’t want – or they don’t know how – to use public transport.
If it’s rainy or the sun is shining too warmly they don’t want to come by bike. Also that the biking route through the city centre is full of temptations that they feel they can’t resist. It’s not yet easy for them to bypass all those pubs and beer gardens. On the contrary, one of the men told us that he had biked to a beer garden straight after our peer group meeting. He explained that the weather was so nice that all his old bad habits came back to his mind and his addiction took the control. As we know it’s a long and bumpy road to overcome alcoholism.
Our clients, middle-aged men with past – or not so past – drinking problems – are mostly people who have had no “normal “hobbies (beside drinking) in their adulthood. They are not familiar with the idea of committing themselves to some activity regularly. Some of them are also shy and they suffer from a lack of social skills. For them it is not easy to come to a group where they don’t know other participants beforehand and it takes time to make them feel comfortable enough to join the meetings.
Attending these Much More peer group meetings are not tied to any financial benefits of the clients. So their livelihood doesn’t depend on taking part in these meetings. That means that our clients have to want to come to the meetings totally voluntarily – so they must feel our group so meaningful that they will come again and again. For us it means that we have to manage to form a group that the clients feel important for them themselves.
How can we make that happen? That’s the question and a major challenge for us professionals. After all, we have decided to find out how we can do that with the Much More project. Together with our clients we have made some plans for the next peer group meetings: we are going fishing, bowling and playing billiards together. That’s what our clients suggested.
In May the Blue Ribbon Association had their meeting outside and made it a barbecue. The weather was nice and the sun was shining.
During the meeting the men started to talk about why they didn’t find watching sports fun anymore. They told that watching sports reminds them about drinking beer because in their past watching sports was always connected to drinking. Nowadays, when they are trying to live without alcohol they don’t want to watch sports anymore because they are afraid that it could be a trigger that makes them drink again. The men said that it is quite easy to become sober but it is so hard to stay and live sober if drinking has been the number one activity of the everyday life.
Later the discussion turned to the life stories of the men and their family and relationship problems. Due to their drinking some of the men had totally lost contact with their children. They felt deeply sad, sorry and guilty because of that but some of them had accepted to live without their children.
Some of the men, for their part, meet their kids regularly. For them building good relationships with their children has been the main reason why they wanted to quit drinking.
After all this eating and talking we planned our next group meeting. The men decided that they would like to fix their bikes next time. They had enjoyed this meeting very much and expressed an interest to continue attending the group.
We started our project here in Turku by a meeting with our local partners from three different organizations that work with substance-abusing clients. Those organizations were: Sininauha Oy, A-kilta and Tietu ry.
Sininauha Oy is a company that works with clients who have had drinking, drug or mental health problems and who have lost their homes. It provides supported rented accommodation for their clients. The work is based on the housing first principle, which means that housing is the primary need. According to this framework housing is the first step of the social rehabilitation for substance abusers. In the meeting we agreed with the Sininauha Oy that their social instructors will encourage some of their male clients to attend our Much More -peer group. The social instructors pick the clients that would benefit our Much More -group and take them to our first meetings.
A-kilta is a non-governmental grass roots support organization. It offers services and support to recovering substance abusers and to their families. A-kilta promotes a substance free lifestyle by day-time activities and peer groups. We are going to co-operate with A-kilta by visiting their unit and by persuading their male clients to attend our Much More -group. We also agreed that Much More -project will organize some small events like barbeque evenings in the A-kilta house to make their clients familiar with Much More -project.
Like A-kilta, Tietu ry is a non-governmental grass roots support organization that provides services and support to people with addictions problems. It provides low-threshold substance abuse counselling. They will try to persuade their male clients to attend our group. They will also offer some professional guidance to our Much More -project if needed.